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Serum voriconazole

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https://www.readbyqxmd.com/read/27866173/a-rapid-uplc-ms-ms-assay-for-the-simultaneous-measurement-of-fluconazole-voriconazole-posaconazole-itraconazole-and-hydroxyitraconazole-concentrations-in-serum
#1
Sankha S Basu, Athena Petrides, Donald S Mason, Petr Jarolim
BACKGROUND: Triazole antifungals are essential to the treatment and prophylaxis of fungal infections. Significant pharmacokinetic variability combined with a clinical need for faster turnaround times has increased demand for in-house therapeutic drug monitoring of these drugs, which is best performed using mass spectrometry-based platforms. However, technical and logistical obstacles to implementing these platforms in hospital laboratories have limited their widespread utilization. Here, we present the development and validation of a fast and simple ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method to measure fluconazole, voriconazole, posaconazole, itraconazole, and hydroxyitraconazole in human serum suitable for incorporation into a hospital clinical laboratory...
November 21, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27648202/antifungal-therapy-in-hematopoietic-stem-cell-transplant-recipients
#2
REVIEW
Alessandro Busca, Livio Pagano
Invasive fungal infections (IFI) represent a major hindrance to the success of hematopoietic stem cell transplantation (HSCT), contributing substantially to morbidity and infection-related mortality. During the most recent years several reports indicate an overall increase of IFI among hematologic patients, in particular, invasive aspergillosis, that may be explained, at least partially, by the fact that diagnoses only suspected in the past, are now more easily established due to the application of serum biomarkers and early use of CT scan...
2016: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/27601292/voriconazole-metabolism-is-influenced-by-severe-inflammation-a-prospective-study
#3
Anette Veringa, Mendy Ter Avest, Lambert F R Span, Edwin R van den Heuvel, Daan J Touw, Jan G Zijlstra, Jos G W Kosterink, Tjip S van der Werf, Jan-Willem C Alffenaar
BACKGROUND: During an infection or inflammation, several drug-metabolizing enzymes in the liver are down-regulated, including cytochrome P450 iso-enzymes. Since voriconazole is extensively metabolized by cytochrome P450 iso-enzymes, the metabolism of voriconazole can be influenced during inflammation via reduced clearance of the drug, resulting in higher voriconazole trough concentrations. OBJECTIVE: To investigate prospectively the influence of inflammation on voriconazole metabolism and voriconazole trough concentrations...
September 6, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27581783/adverse-effects-of-voriconazole-over-a-decade-of-use
#4
Miriam T Levine, Pranatharthi H Chandrasekar
Voriconazole use has increased since the drug's introduction in 2002, and new and unique adverse effects are emerging as patients undergo prolonged therapy. Most concerning is the increased risk of cutaneous malignancies, primarily squamous cell carcinoma (SCC); this risk is duration dependent and the associated malignancies tend to be more aggressive and multifocal. Voriconazole is also associated with phototoxicity (which may be a precursor to malignancy), periostitis, hallucinations and encephalopathy, peripheral neuropathy, alopecia, nail changes, hyponatremia, and other adverse effects...
September 1, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27548272/an-optimized-voriconazole-dosing-strategy-to-achieve-therapeutic-serum-concentrations-in-children-younger-than-2-years-old
#5
Tracy N Zembles, Nathan E Thompson, Peter L Havens, Bruce A Kaufman, Anna R Huppler
STUDY OBJECTIVE: To describe our experience with voriconazole in three patients younger than 2 years using an optimized dosing strategy for voriconazole that incorporates intensive therapeutic drug monitoring (TDM). DESIGN: Case series. SETTING: Large pediatric hospital. PATIENTS: Three patients younger than 2 years who received voriconazole therapy and had serum trough concentrations measured between January 1, 2010, and October 31, 2015...
October 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27543657/in-vitro-activity-of-anidulafungin-in-combination-with-amphotericin-b-or-voriconazole-against-biofilms-of-five-candida-species
#6
A Valentín, E Cantón, J Pemán, M E Fernandez-Rivero, M A Tormo-Mas, J P Martínez
OBJECTIVES: To evaluate the in vitro activity of anidulafungin combined with amphotericin B or voriconazole against Candida spp. biofilms. METHODS: Four Candida albicans, four Candida tropicalis, four Candida glabrata, two Candida parapsilosis and two Candida orthopsilosis blood isolates were tested by the microdilution chequerboard method combined with the XTT metabolic assay. Biofilm MIC was defined as the lowest concentration producing 50% metabolic inhibition with respect to control (BMIC50)...
August 19, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27536124/role-of-isavuconazole-in-the-treatment-of-invasive-fungal-infections
#7
REVIEW
Dustin T Wilson, V Paul Dimondi, Steven W Johnson, Travis M Jones, Richard H Drew
Despite recent advances in both diagnosis and prevention, the incidence of invasive fungal infections continues to rise. Available antifungal agents to treat invasive fungal infections include polyenes, triazoles, and echinocandins. Unfortunately, individual agents within each class may be limited by spectrum of activity, resistance, lack of oral formulations, significant adverse event profiles, substantial drug-drug interactions, and/or variable pharmacokinetic profiles. Isavuconazole, a second-generation triazole, was approved by the US Food and Drug Administration in March 2015 and the European Medicines Agency in July 2015 for the treatment of adults with invasive aspergillosis (IA) or mucormycosis...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27516796/invasive-aspergillosis-successfully-treated-by-combined-antifungal-therapy-and-immunosuppressive-monotherapy-two-months-following-heart-transplantation
#8
Tomasz Urbanowicz, Bartłomiej Żabicki, Hanna Baszyńska-Wachowiak, Ewa Straburzyńska-Migaj, Robert Juszkat, Stefan Grajek, Marek Jemielity
Invasive aspergillosis is becoming increasingly prevalent, especially following transplantation. Invasive aspergillosis is associated with mortality. Successful therapy is related to early diagnosis and proper therapy. We present the case of a 61-year-old man suffering from invasive aspergillosis 2 months following heart transplantation. He was suffering from hypertrophic cardiomyopathy and he underwent orthotropic heart transplantation. He was readmitted to the Department of Cardiology 69 days following transplantation due to symptoms of productive cough for 5 days...
June 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/27494912/dose-optimization-of-voriconazole-anidulafungin-combination-against-aspergillus-fumigatus-using-an-in-vitro-pharmacokinetic-pharmacodynamic-model-and-response-surface-analysis-clinical-implications-for-azole-resistant-aspergillosis
#9
Maria Siopi, Nikolaos Siafakas, Sophia Vourli, Johan W Mouton, Loukia Zerva, Joseph Meletiadis
BACKGROUND: Combination therapy of voriconazole with an echinocandin is often employed in order to increase the efficacy of voriconazole monotherapy. METHODS: Four clinical Aspergillus fumigatus isolates with different in vitro susceptibilities to voriconazole (MIC 0.125-2 mg/L) and anidulafungin (MEC 0.008-0.016 mg/L) were tested in an in vitro pharmacokinetic/pharmacodynamic model simulating human serum concentrations of standard dosages of voriconazole and anidulafungin...
November 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27314989/-analysis-of-voriconazole-serum-concentrations-and-safety-profile-in-pediatric-oncology-patients
#10
Felipe Silva, Daniel Navea, Carolina Saias, Juan P Torres, Paula Catalán, Jorge Morales
BACKGROUND: Voriconazole (VCZ) serum drug levels (SDL) vary widely and are associated with increased mortality when they are below the therapeutic range for invasive aspergillosis (IA). AIM: To describe VCZ SDL in oncology pediatric patients in order to reach adequate concentrations for prophylaxis (≥ 0.5 mg/L) and treatment (≥ 1.0 y 2.0 mg/L) for IA and their relationship with toxicity. PATIENTS AND METHODS: Retrospective analysis of VCZ SDL and toxicities recorded in oncology pediatric patients between February 2013 and November 2014...
April 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/27313918/neurologic-adverse-events-associated-with-voriconazole-therapy-report-of-two-pediatric-cases
#11
Sevliya Öcal Demir, Serkan Atici, Gülşen Akkoç, Nurhayat Yakut, Nilay Baş İkizoğlu, Ela Erdem Eralp, Ahmet Soysal, Mustafa Bakir
Although voriconazole, a triazole antifungal, is a safe drug, treatment with this agent is associated with certain adverse events such as hepatic, neurologic, and visual disturbances. The current report presents two cases, one a 9-year-old boy and the other a 17-year-old girl, who experienced neurologic side effects associated with voriconazole therapy. Our aim is to remind readers of the side effects of voriconazole therapy in order to prevent unnecessary investigations especially for psychological and ophthalmologic problems...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27302916/erratum-therapeutic-drug-monitoring-of-voriconazole-helps-to-decrease-the-percentage-of-patients-with-off-target-trough-serum-levels
#12
(no author information available yet)
No abstract text is available yet for this article.
August 1, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27291972/development-and-characterization-of-voriconazole-loaded-nanoparticles-for-parenteral-delivery
#13
Petra Füredi, Kristóf Kovács, Krisztina Ludányi, István Antal, Imre Klebovich
Human serum albumin (HSA) has attracted the most attention in the last decades as a new nanocarrier system of active pharmaceutical ingredients (API) due to its biocompatibility and high binding capacity to hydrophobic drugs. Voriconazole (VCZ), an antifungal agent with low water solubility, was selected to produce albumin based nanoparticles using nanoparticle albumin-bound technology (nab™-technology). Aim of our study was to study the development process of VCZ-loaded nanoparticles for parenteral drug delivery, such as homogenizing pressure, homogenizing cycle number and drug loading capacity...
August 20, 2016: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/27249894/clinical-features-and-survival-outcomes-of-invasive-aspergillosis-in-pediatric-patients-at-a-medical-school-in-thailand
#14
Suvaporn Anugulruengkitt, Panruethai Trinavarat, Punchavit Chantranuwat, Suchada Sritippayawan, Chitsanu Pancharoen, Puthanakit Thanyawee
BACKGROUND: Invasive aspergillosis (IA) is a severe infection in immunocompromised patients. Recently, serum galactomannan has been widely used for diagnosis and voriconazole as an antifungal agent. The objective of this study is to describe clinical features and survival outcomes of IA. MATERIAL AND METHOD: A retrospective chart review of IA in patients younger than 18 years old at King Chulalongkorn Memorial Hospital, Thailand, was conducted. Clinical definitions were based on criteria oft he European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) 2008...
February 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
https://www.readbyqxmd.com/read/27165788/utility-of-voriconazole-therapeutic-drug-monitoring-a-meta-analysis
#15
Me-Linh Luong, Mona Al-Dabbagh, Andreas H Groll, Zdenek Racil, Yasuhito Nannya, Dimitra Mitsani, Shahid Husain
BACKGROUND: Voriconazole therapeutic drug monitoring (TDM) is increasingly used in clinical practice. However, the utility of voriconazole TDM to guide therapy remains uncertain and controversial. We conducted a meta-analysis of studies assessing the relationship between voriconazole serum concentration and clinical outcomes of success and toxicity. METHODS: We searched bibliographic databases for studies on voriconazole serum concentrations and clinical outcomes...
July 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27161787/cutaneous-hyalohyphomycosis-due-to-parengyodontium-album-gen-et-comb-nov
#16
Chi-Ching Tsang, Jasper F W Chan, Wai-Mei Pong, Jonathan H K Chen, Antonio H Y Ngan, Mei Cheung, Christopher K C Lai, Dominic N C Tsang, Susanna K P Lau, Patrick C Y Woo
"Engyodontium album" is an environmental saprobic mould and an emerging opportunistic pathogen able to cause both superficial and systemic infections. In this study, we isolated a mould from the skin lesion biopsy specimen of the right shin in a patient who received renal transplantation for end-stage renal failure with prednisolone, tacrolimus, and azathioprine immunosuppressant therapy. Histology of the skin biopsy showed mild squamous hyperplasia and neutrophilic infiltrate in the epidermis, active chronic inflammation in the dermis, and fat necrosis in the subcutis, with numerous fungal elements within the serum crusts...
October 1, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27161786/triazole-antifungals-used-for-prophylaxis-and-treatment-of-invasive-fungal-disease-in-adult-haematology-patients-trough-serum-concentrations-in-relation-to-outcome
#17
M Mansour Ceesay, Lewis Couchman, Melvyn Smith, Jim Wade, Robert J Flanagan, Antonio Pagliuca
Triazole antifungal drugs are widely used for the prophylaxis and treatment of invasive fungal disease (IFD). Efficacy may depend on attaining minimum effective plasma concentrations. The aim of this study was to ascertain the proportion of samples in which the recommended concentrations were achieved in patients given these drugs in relation to outcome. In-patients prescribed standard doses of fluconazole, itraconazole solution, posaconazole suspension, or oral voriconazole for at least one week were studied...
October 1, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27105907/clinical-presentation-and-determinants-of-mortality-of-invasive-pulmonary-aspergillosis-in-kidney-transplant-recipients-a-multinational-cohort-study
#18
F López-Medrano, M Fernández-Ruiz, J T Silva, P L Carver, C van Delden, E Merino, M J Pérez-Saez, M Montero, J Coussement, M de Abreu Mazzolin, C Cervera, L Santos, N Sabé, A Scemla, E Cordero, L Cruzado-Vega, P L Martín-Moreno, Ó Len, E Rudas, A P de León, M Arriola, R Lauzurica, M David, C González-Rico, F Henríquez-Palop, J Fortún, M Nucci, O Manuel, J R Paño-Pardo, M Montejo, P Muñoz, B Sánchez-Sobrino, A Mazuecos, J Pascual, J P Horcajada, T Lecompte, A Moreno, J Carratalà, M Blanes, D Hernández, M C Fariñas, A Andrés, J M Aguado
The prognostic factors and optimal therapy for invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT) remain poorly studied. We included in this multinational retrospective study 112 recipients diagnosed with probable (75.0% of cases) or proven (25.0%) IPA between 2000 and 2013. The median interval from transplantation to diagnosis was 230 days. Cough, fever, and expectoration were the most common symptoms at presentation. Bilateral pulmonary involvement was observed in 63.6% of cases. Positivity rates for the galactomannan assay in serum and bronchoalveolar lavage samples were 61...
November 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/26960808/changes-of-serum-aspergillus-galactomannan-during-hematopoietic-stem-cell-transplantation-in-children-with-prior-invasive-aspergillosis
#19
Te-Fu Weng, Kang-Hsi Wu, Han-Ping Wu, Ching-Tien Peng, Yu-Hua Chao
BACKGROUND: Invasive aspergillosis (IA) has recently increased and has a high mortality rate in immunocompromised patients. IA before hematopoietic stem cell transplantation (HSCT) is not uncommon, but how to cope with it is very tough. The serum aspergillus galactomannan antigen (GM) is a helpful marker for diagnosis of IA, and a serial follow-up of GM levels is important to evaluate the response of treatment. However, data on the changes of GM during HSCT are very limited. CASE PRESENTATION: Patient 1 was a 2-year-old female with severe aplastic anemia...
2016: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/26957063/-clinical-analysis-of-16-cases-of-invasive-pulmonary-aspergillosis-in-children
#20
Yong Li, Guangmin Nong, Min Jiang, Jing Liu, Xiuan Liang
OBJECTIVE: To investigate the diagnosis and treatment of invasive pulmonary aspergillosis (IPA) in children. METHOD: The clinical data of 16 cases of proven or probable IPA who had been in our Hospital from January 2006 to June 2014 were retrospectively analyzed. RESULT: Among the 16 patients, 11 were males and 5 were females. One child had proven IPA and 15 children had probable IPA. Host risk included long duration use of multiple broad-spectrum antibiotics in 16 cases, neutropenia in 9 cases, invasive mechanical ventilation in 3 cases, primary immunodeficiency disease in 2 cases, long-term use of glucocorticoids in 2 cases, measles in 2 cases, and congenital pulmonary hypoplasia in 1 case...
March 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
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